blueeowyn: (Tigger and Pooh)
[personal profile] blueeowyn
Death is one of those things that a lot of people don't want to think about or talk about. It is big, scary, and unpleasant. However, dealing with death goes a LOT smoother if there is preparation ahead of time. At the very least having someone with organizational skills and the ability to focus during the stress is very helpful.

Here are a few things that I have seen/learned over the last several years with regards to dealing with death. I am not a lawyer, I am not a clergy member, I am not a doctor, and I do live in Maryland. Different people will have different thoughts and different areas may have different rules. Feel free to email me (username AT dreamwidth and logical extension) if you don't want to comment with your name.




If you suspect someone is going to die soon (or that you will be involved when a person dies) or you just want to be prepared; getting some of the information NOW (or knowing where to find it) can be very helpful. There is a lot that does have to be dealt with and it can be overwhelming. It is easy to get caught up in all the stuff and either get taken for a ride, or drop some balls that shouldn't be dropped.


If there are family members who are not close by, make sure that they know what is going on. Sometimes the message of the seriousness of illness gets diluted as it goes through a chain (selective hearing/reading; wanting to cushion the blow; not wanting to admit it to self; etc.). If someone is dying, visits when they are still healthy enough to participate in them and enjoy them are better than everyone sitting around someone in a coma. If the death is fairly imminent (e.g. planning to stop life-support on day X), distant people will need the time to arrange to come to the visitation/funeral and the more time the better).

Things to discuss with someone before they are really sick/old/in an accident:
Maryland has a lot of options of things that can be done well in advance of need. If someone is sick/injured how much intervention do they want? Some people want everything possible done, some want some intervention but don't want to cross certain lines, others want to let nature takes its course beyond very minimal interventions. Maryland has something called Maryland Order for Life Sustaining Treatment (https://www.miemss.org/home/molst) which can be very helpful to go through, fill out, and discuss (esp. with the person/people authorized to make decisions on your behalf). There are also Advance Directives (https://www.marylandattorneygeneral.gov/Pages/HealthPolicy/AdvanceDirectives.aspx) which seem to overlap the MOLST. I suspect that both are a good thing. It helps you think about what the possible interventions are and what is appropriate to this person. Intubation is one of those things that once it has been done, getting it undone can be an uphill battle and my understanding is that being awake while intubated is pretty miserable. What is right for a person may change as they age or their health changes so checking the document periodically and updating (and filing the updates) is probably helpful, this is incredibly important as someone ages and fails a bit, if you know someone is sick enough to need major medical intervention but you also know they don't want it, how liable legally will you be if you do or don't call for help? I don't know. There are also Advance Directives and variations of DNR orders that can be discussed/planned.

Another area to think about is if someone is terminally ill, what do they want short term and long term. Some people refuse to admit (either to themselves or to their family) that this is terminal, others are more open and some will admit to some people but not others. Depending on where on the acceptance continuum, there are choices to be made regarding which medical interventions are reasonable/acceptable and which are not. Hospice (https://mhcc.maryland.gov/consumerinfo/longtermcare/Hospice.aspx) is a wonderful support option for people (and their families) who are terminally ill. I've had friends who used a hospice service and others who have volunteered. I am sure that there are some variations but the idea behind hospice is that the patient should be as pain free as possible and have the best quality of life for whatever time they have left. Smaller interventions that will increase time without decreasing quality are common (e.g. portable oxygen for someone dying of lung cancer). The treatments are focused on that quality rather than prolonging life. The support for the patient and family does continue after the death and includes things like explanations of what is happening and why they make certain recommendations.

If there is a need for a guardianship and/or medical power of attorney, make sure that this is sorted out AND that the order is correct.




Things to know/discuss with someone before their death:
What are the answers to the questions for the death certificate. While "Unknown" can be listed, I suspect that the more information that can be matched, the better, especially with a more common name:

  • Full name
  • Date of Death
  • Date of Birth
  • gender
  • state of birth
  • usual residence address (including county)
  • SSN
  • Citizenship nation
  • marital status
  • did the person serve in armed forces? if so, which branch
  • race/ethnicity
  • education level
  • usual occupation (prior to retirement) and the type of industry
  • sire's first & last name
  • mother's first name & maiden name,
  • next of kin (name, address, relationship, phone number). You may not have to know all of this but you do need to know where to find it out.


Does the person have any preferences as to what happens to their body? Some people feel very strongly about some of the options. If the person dies in a hospital, you have a little time to find a funeral service (it was 72 hours for us) but knowing what you want makes things a LOT easier. Cremation? Burial (does the person own a plot already? where is the paperwork?), mausoleum (ditto). Has the person prepaid for certain services (which can save a lot of money but you need the information and the person needs to live near where the prepaid service is). Is there to be a body at the wake/funeral/memorial service/celebration of life? If so, timing becomes an issue and embalming is likely to become required. Does the person want viewings (or not)? How much do the survivors want to deal with stuff vs. having the funeral home handle it? With Pete we used MD Cremation Society which is a no frills service (they file things, get the death certificates and cremate the body, you can do a SMALL viewing at their location but they don't embalm, they don't set up a montage of pictures, etc.) and they were several thousand less than a more traditional funeral home. They were also kind and respectful towards us when we have used them and in one case we were able to file the paperwork before the death (though we had to prove financial power of attorney to do that).

Getting info on what type of music/service/etc. the person wants can be helpful ... it is so sad when everyone has a different idea on what "Bob" would have wanted and it can lead to family rift. Is the person active in a church or lodge or similar? Is there someone who 'should' speak and will that person be able to speak? I have known of people who chose all of the music, the readings, the church, and had suggestions of speakers. Will there be a graveside service (for burial/mausoleum) for just family? Will there be a mercy feast? Who should provide it (some cultures the family feeds the gathering, in other situations friends provide food for the people closest to the deceased). What causes did the person support (so you have a "in lieu of flowers" idea already lined up)?

Who are friends/family/etc. that the person has that you may not know? What is the best way to get in touch with them? Who are the doctors the person has? This can be used for coordinating care during end of life and for contacts after death.


Logistics
If you (and they) are OK with it, being on any bank accounts so that after they pass you can deposit stuff and pay their bills with their money (mortgage, utilities, credit cards). It isn't uncommon for people to have a savings account and move money to their checking account as needed (less for people to steal if they get the account number) so you may need access to both.

Have some idea of the number of accounts the person has (credit cards, bank accounts, stock account, insurance, pension, social security, etc..). This will help you get the right number of death certificates (many places still need to see the original so you may be mailing a bunch of them out ... others will look at it, copy it and return the original). It will also help whomever is dealing with the estate to set up the estate correctly. Whose name are the utilities under? Do you have chain of access to update them as needed (e.g. widow kept husband's name on accounts)? Is there a safe deposit box, if so, which bank location is it at?

Is there a will? Who has a copy? Who is the representative/executer? Does this person know what is coming (if not, this is a great time to explain things)? Is this person still the correct choice? Checking your will every now and again and updating who the PR is may be a worthwhile thing to do (maybe the person isn't very competent, or lives out of state, or has proven to be unreliable, or ...) and can also allow you to update with any major changes (are your children no longer dependents who need guardians, has your financial situation changed, are there bequests that need updating).

It can sound like a good idea to have joint executers but in reality it can create a lot of issues, especially if it is a situation where the 2 people aren't in physical proximity. It makes MORE sense to list a primary, secondary, tertiary, etc. so that if the primary can't do it (for whatever reason) there is a reasonable list. As with other aspects of the will, updating this from time to time is never a bad idea. The executer/representative will likely need a lawyer if it is a 'large' estate because there is a lot more stuff to file. Some things can take quite awhile to work through the system so that things can start being done.

What are the bequests that the person wants to give? Do they still make sense to the person (again, checking the will every so often is helpful)? If someone gives a certain amount of money to people in a specific order then have the rest of the estate divided equally among others, it is possible that those little bequests will eat up all the of the estate and the divided equally piece is reduced to nothing. Another reason to update wills occasionally but I suspect that you can say that Bob gets $5000 or up to 10% of the estate, whichever is less. Does there need to be a bond issued before opening the estate (apparently if you say no bond in the will, there doesn't need to be one, otherwise one is required for a large estate).

Legally nothing of value should be removed from the home before it is appraised. There can be reasons to temporarily relocate stuff but document it and have it back for the appraisal. Things that don't have value (food, trash, newspapers) can be disposed of. After the house and contents are appraised, you can start going through stuff. Anything that was declared to have value (no matter how small a value) needs to be documented on what happens to it. Expenses that are incurred on behalf of the estate also need to be fully documented (e.g. [store] [date] purchase of [paint, trashbags, whatever] and keep the receipts. If you have a credit card that you can afford to not use for anything else for awhile, make it the card you use for everything you can for the estate so you have a single place of truth of costs.). In Maryland, you can do work on the house for the estate, however, you cannot charge the estate for your time/effort (you can charge for the paint, trashbags).

Once the estate is mostly sorted out and the information is filed, there can be questions about things to verify worth (or lack thereof), whether things should have been included that weren't, etc.. This is one of those times when having a lawyer who is up to date on estates can be VERY helpful.

Also, getting mail forwarded at the right time is good, doing it BEFORE the house is fully emptied can be a good idea (otherwise, the postal service may realize that the house is vacant and stop the mail and return some of it).



Things to do after the person has passed:
Gather all the info for the death certificate (name, SSN, education, military, relatives, etc.)

Contact funeral homes, I suggest someone either uses a burner email address or someone who has some distance (emotionally) does this. Once you know what you are asking for, you can price shop a bit. When we were doing this for Pete, the prices for what we wanted ranged from 1300ish to 4700ish. Even the death certificate price varied (360, 372, 610) for the same number of certificates. Do NOT let them get the grieving spouse/child on the phone. Some places are perfectly reputable, others are less so and likely to push for posher arrangements that will cost a lot more ("Don't you want your beloved [husband/wife/child/mother/father/etc.] to have the [coffin/flowers/music/etc.] that they deserve?").

If the person went to church, contact the church to let them know of the passing. Talk to the family about timing of a service (if you are going to have a body there, it needs to be sooner since storing a body will cost), any viewing prior/after the service, any service at any internment, any visitation times etc.. Talk to the church about reserving the space/time, getting the officiant, etc.. Usually a church will host a service for free or very economically for their member.

If the person lived alone, are there pets in the house that need to be cared for? is there concern that the house will be vacant? Are there valuables in the house that need to be itemized just in case? Who will take responsibility for paying the maintenance of the house (mortgage, utilities, insurance, lawn-mowing, etc.)? Who will be responsible for going through the house and separating stuff into "memories" vs. "sell" vs. "donate" vs. "inheritance"? How long will that take before the house/condo can go on the market? In Maryland, apparently an estate cannot be dispersed other than paying bills for 6 months after the estate is established with the courts. This allows any creditors time to petition for payment (such as the hospital where the person died). That means that someone has to keep things going for that amount of time before disbursements of inheritance of value and/or selling the house/condo.

When the estate is established, the value of the estate apparently affects a lot of things. In Maryland the magic number is apparently $50,000 where below it the small (and relatively simple estate) is an option. Above that amount, it is a large estate and has more rules (http://registers.maryland.gov/main/forms.html)

Call all the doctors and cancel any future appointments, update records, etc.. It is really hard on someone to get a call "So and so has an appointment tomorrow with Dr. Blah Blah" or worse yet, have to pay a no-show fee for someone who has been dead for 3 weeks because you didn't get the message in time to cancel.

Call/email magazines to cancel the subscription, include information on to whom any refund check should be made (it gets awkward when you get checks for the dead person) and saves the survivor the pain of getting rid of magazines that they don't want that were important to the deceased person.

Contact any pension fund and see about dealing with that (if there is a surviving spouse, they may be entitled to some pension but there will be forms required). Contact Social Security to have any payments stopped (you may need to return stuff that was done between death and the notification).

Contact any life insurance and deal with that

Write a SHORT notice for the newspaper (if wanted), they charge by the inch and even a short death notice will run up quite a bill and most people won't see it unless they happen to search on the name. Are there on-line options available that are more reasonable (many funeral homes have options). If there are organizations or societies that the deceased was active in, a notice to them might be nice.

Keep a list of who has been contacted (by type of person) if multiple people are working on it. When my mom's husband died I had a list of magazines that I had contacted, I had a list of doctors, a list of funeral homes, etc.. It helped a LOT. Whenever I called someone on my mom's behalf, I would give her an update on what was said and what needed to be done.

If you are dealing with the loss of a loved one, let yourself grieve, don't make big life changing decisions right away. You won't be thinking straight for a bit and you will be able to think again but it will take some time. Most decisions can wait (and things like pensions aren't decisions, they are notifications).




If someone you know is dealing with death
Reach out to them, let them talk or if they don't want to talk, share silence.

Send cards and notes. Give hugs. Provide food (if appropriate). When my FIL died, my co-worker showed up at the visitation and brought pizza for the time between that and the service so the whole family had something to eat without having to think about or deal with it.

Attend the service, even if it isn't your religion, it can mean so much to the family.

Offer to do some of the administrivia (if you are able to), or go with the person while they deal with it (MVA is a bear). Help them stay organized as they deal with what has to be dealt with.

Offer to help with any cleaning/sorting if you are close enough to them that it won't feel like an intrusion or even to sit with them while they do it.

Offer to help move stuff to the curb for pick-up (donation or trash)

Share as much of this as you think is relevant for them



What I Want - link to a post that lists what my personal preferences are regarding my body post death.

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